This is a short form used to determine your requirements for digital use and rights licensing of my artwork. This is a questionnaire only, there is NO binding agreement upon completion of this form. Upon receipt of this completed questionnaire I will provide you with a simple price quote for a rights or usage license, or--you may request the quote be incorporated into a completed (but not executed) Agreement (see question [specific request] toward the end of this survey for selecting your preference of those two options). Once I produce the completed contract, including the price for licensing--I will forward same to your preferred email address. The Agreement will not be executed (binding) until payment is tendered for the license. If you have questions or wish changes to the terms & conditions, I will submit a revised contract based on our further discussions and agreements.
Email address *
Legal Name of LICENSEE *
Your answer
If for e-publication or website, please indicate page or space proportion. *
Please indicate desired size or approx. size. *
Requested pixel dimension will be provided @ 150 DPI (quality)
Approximate running time of promotion or use? *
Nature of ad or publication? *
if for email blast, please indicate audience size in the following question
For email blast or publication (size of blast) *
Exclusivity *
Specific Request *
Select option (1) if you wish a simple price quote based on the answers to this questionnaire. Select option (2) if you would like me to send you a contract for licensing, with the price included in the Agreement. ***Note: for option (2) this is a contract submitted for your review. There is no binding Agreement between you and me (as outlined in the Agreement) until full payment is made of the price quoted in the Agreement.
Questions or comments
If you have questions or comments pertaining to any of your responses, or would like to provide additional information to your answers... please use the space provided below. Thank-You.
Your answer
A copy of your responses will be emailed to the address you provided.
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This form was created inside of the boston artist.